NPIMap

Organization Active NPI

Accura Medical Laboratory Inc

  • Clinical Medical Laboratory
  • O Fallon, MO
National Provider Identifier
1831222595
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
26D0691515 Issued in MO
Legal business name
ACCURA MEDICAL LABORATORY INC
Practice address
206 S Main St
O Fallon, MO 63366-2805
Phone
(636) 978-2228
Fax
(636) 240-0144
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Prakob Karl Pongspikul, MT(ASCP), SC, MBA
Title
President
Phone
(636) 978-2228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 26D0691515 MO Primary

Addresses

Primary practice location

206 S Main St
O Fallon, MO 63366-2805

Mailing address

206 S Main St
O Fallon, MO 63366-2805
Phone (636) 978-2228

Other identifiers 1

IdentifierTypeStateIssuer
702946807MedicaidMO

National Provider Directory

National Provider Directory

Locations

206 S Main St
Ste A
O Fallon, MO 63366
Phone (636) 978-2228

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1831222595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662805",
            "telephone_number": "636-978-2228",
            "fax_number": "636-240-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662805",
            "telephone_number": "636-978-2228",
            "fax_number": "636-240-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCURA MEDICAL LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "PONGSPIKUL",
        "authorized_official_first_name": "PRAKOB",
        "authorized_official_middle_name": "KARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-978-2228",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MT(ASCP), SC, MBA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MO",
            "license": "26D0691515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "702946807",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.